The risks of gluten allergies have been underestimated,
according to a study that found increased
mortality rates among people with coeliac disease.
Coeliac disease is triggered by exposure to gluten, a protein
found in wheat, rye and barley.
Found in about 1% of the Western population, it damages
the small intestines and interferes with the absorption of
nutrients from food.
People with coeliac disease often also have other diseases that
attack the immune system such as diabetes or arthritis.
However, coeliac disease often goes undiagnosed until substantial
damage has been done to the digestive system.
Risk 'modestly increased'
Using data taken from biopsies taken between July 1969 and
February 2008 in Sweden, researchers were able to examine the
overall risk of death in individuals with coeliac disease and
digestive inflammation and compare it to the general population.
They found the risk of death was "modestly increased".
Patients with inflammation had a 72% increased risk of
death; patients with coeliac disease had a 39% increased
risk; and patients with latent coeliac disease had a 35%
increased risk of death.
Lead author Jonas Ludvigsson of the Orebro University Hospital
concluded that there could be several explanations for the
increased mortality risks.
"Malnutrition of energy and vitamins and chronic inflammation
may increase the risk of death," he wrote, noting that even
patients who maintain gluten-free diets have persisting lesions.
Coeliac disease: an important diagnosis
Those with inflammation who had not been diagnosed with coeliac
disease may have an overall worse prognosis because institution of
a gluten-free diet often leads to normalisation, the authors
"Until recently, gluten sensitivity has received little
attention in the traditional medical literature, although there is
increasing evidence for its presence in patients with various
neurological disorders and psychiatric problems," Peter Green of
Columbia University College of Physicians and Surgeons wrote in an
"The study by Ludvigsson and colleagues reinforces the
importance of coeliac disease as a diagnosis that should be sought
by physicians. It also suggests that more attention should be given
to the lesser degrees of intestinal inflammation and gluten
The risk of death was highest in the first year of follow-up but
decreased with age at diagnosis, with risk being higher for those
diagnosed before age 20.
The study was published in the Journal of the American Medical
(Sapa, September 2009)
Read more: Gluten sensitivity